Thyroid carcinoma in Nigeria: review of management

The records of 54 patients with thyroid carcinoma who were managed at the Department of Radiation Biology and Radiotherapy, Lagos University Teaching Hospital between 1973 and 1985 were reviewed. Most of the patients lived in the goitre-endemic belt of Southern Nigeria even though only about 14% of them were found to have had treatment in the past for what was considered to be benign thyroid enlargement. The predominant histological type was follicular carcinoma, which represented 42.9%; the female to male ratio was 2.9 to 1. Surgery, which was the initial treatment of these patients, was limited to the amount of disease present at operation in most cases so as to limit postoperative complications. The indications for other treatments employed which included radiotherapy, radioactive iodine therapy and postoperative suppression with thyroxine are discussed. Forty-eight percent of all the patients developed recurrence after treatment while 88% of these patients with recurrence had distant metastases. The 5-year survival rate was 43% after which many patients were lost to follow-up.